Care Bear’s Tonic? Actually CBT’s not that different
Experts on sleep are converging on Glasgow this September for the annual conference of the European Sleep Research Society (ESRS). In celebration, let’s take Scotland as our point of interest for this post. As a country, Scotland has a population of some 5 million hardy souls. Yet, every year sees Scottish doctors hand out some 30 million sleeping pills. Local politicians don’t appear on television often enough to send the country to sleep naturally.
Why are so many pills dispensed? The answer is very simple. Despite all the evidence demonstrating how effective Cognitive Behavioural Therapy (CBT) is to show people how to regain their ability to sleep, the National Health Service does not pay for it. The result? Less than 1% of those who have sleep disorders get therapy. Doctors have little choice than to prescribe Ambien, sometimes alongside antidepressants.
Why is CBT so effective? In one-to-one training, people learn how to change the way they think and behave. This is not the talk-talk of psychiatry which explores more abstract ideas. It focuses on practical steps to relieve the problems that contribute to disrupted sleep. This means changing the home environment and building new habit patterns. In most cases, the people find their ability to sleep improves. This beats the alternatives. There’s no evidence that taking sleeping pills like Ambien over a long period of time does anything to treat the underlying causes of the sleep disorder. All the medication does is to relieve the more obvious symptoms until tolerance build up and the effectiveness of the medication is lost. Except the price of long-term exposure is often addiction.
The figures estimate that about 10% of Scotland’s population suffers from persistent insomnia. Research shows that most would prefer treatment that did not rely on the use of drugs. There’s a steady demand for books on insomnia and many wait months for appointments to come in the clinics that offer private treatment. As a departure from its previous resistance, the Scottish Government has recently made £1 million available to fund a CBT pilot scheme. Until the civil servants prove the effectiveness of the therapy, the rest of Scotland will just have to keep taking the Ambien and watch DVDs of the Care Bears to encourage sleep.